Provider Demographics
NPI:1821872490
Name:VAZQUEZ CABALLERO, ADRIANA YORDANKA (RBT-23-285439)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:YORDANKA
Last Name:VAZQUEZ CABALLERO
Suffix:
Gender:F
Credentials:RBT-23-285439
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6027 CRESTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4921
Mailing Address - Country:US
Mailing Address - Phone:813-947-0631
Mailing Address - Fax:
Practice Address - Street 1:3309 W WATERS AVE STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2766
Practice Address - Country:US
Practice Address - Phone:813-898-0014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-285439106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician